Ekonomi Bölümü Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.11779/1936
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Browsing Ekonomi Bölümü Koleksiyonu by Institution Author "Başer, Onur"
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Conference Object A Comparative Analysis of the Health Care Utilization and Costs of Patients Diagnosed With and Without Liver Cancer in the Us Medicare Population(2017) Ogbomo, A.; Lin, Y.; Keshishian, A; Xie, L; Yuce, H; Başer, Onur...Article Citation - WoS: 18Citation - Scopus: 18Adding Rapid-Acting Insulin or Glp-1 Receptor Agonist To Basal Insulin: Outcomes in a Community Setting(2015) Dalal, Mehul R; DiGenio, Andres; Xie, Lin; Başer, OnurTo evaluate real-world outcomes in patients with type 2 diabetes mellitus (T2DM)receiving basal insulin, who initiate add-on therapy with a rapid-acting insulin (RAI) or aglucagon-like peptide 1 (GLP-1) receptor agonist.Data were extracted retrospectively from a U.S. health claims database. Adults withT2DM on basal insulin who added an RAI (basal+RAI) or GLP-1 receptor agonist (basal+GLP-1) were included. Propensity score matching (1 up to 3 ratio) was used to control for differencesin baseline demographics, clinical characteristics, and health resource utilization. Endpointsincluded prevalence of hypoglycemia, pancreatic events, all-cause and diabetes-relatedresource utilization, and costs at 1 year follow-up. Overall, 6,718 matched patients were included: 5,013 basal+RAI and 1,705basal+GLP1. Patients in both groups experienced a similar proportion of any hypoglycemicevent (P = .4079). Hypoglycemic events leading to hospitalization were higher in the basal+RAIcohort (2.7% vs. 1.8%; P = .0444). The basal+GLP-1 cohort experienced fewer all-cause(13.55% vs. 18.61%; P<.0001) and diabetes-related hospitalizations (11.79% vs. 15.68%;P<.0001). The basal+GLP-1 cohort had lower total all-cause health care costs ($18,413 vs.$20,821; P = .0002), but similar diabetes-related costs ($9,134 vs. $8,985; P<.0001) comparedwith the basal+RAI cohort. Add-on therapy with a GLP-1 receptor agonist in T2DM patients receiving basalinsulin was associated with fewer hospitalizations and lower total all-cause costs compared withadd-on therapy using a RAI, and could be considered an alternative to a RAI in certain patientswith T2DM, who do not achieve effective glycemic control with basal insulin.Conference Object Assessing Health Care Resource Utilization and Costs Among Us Veterans Diagnosed With Asthma(2016) Ogbomo, A; Tan, H; Kariburyo, F; Xie, L; Başer, Onur...Conference Object Assessing the Economic Burden and Health Care Resource Utilization of Us Veterans With Chronic Obstructive Pulmonary Disease(2016) Ogbomo, A; Tan, H; Kariburyo, F; Xie, L; Başer, Onur...Conference Object Assessing the Economic Burden and Health Care Utilization of Attention Deficit/Hyperactivity Disorder Among Us Medicaid Patients(2016) Zhang Q; Zhao, Y; Keshishian, A; Xie, L; Yuce, H; Başer, Onur...Conference Object Assessing the Economic Burden of Rheumatoid Arthritis Patients With Different Clinical Disease Activity Index Scores: a Probabilistic Matching Study(2016) Kariburyo, F; Du, J; Xie, L; Başer, OnurTo evaluate the health care resource utilization and economic burdenof rheumatoid arthritis (RA) based on the Clinical Disease Activity Index(CDAI). Adult patients diagnosed with RA (International Classificationof Diseases, Ninth Revision, Clinical Modification code 714.xx) were identified froma large claims database and a RA registry from 2006-2015. Patients identified wereprobabilistically matched with a 1:1 ratio based on age, gender, state, and indexyear. The first RA diagnosis date was designated as the index date. Patients wererequired to have continuous health plan enrollment with medical and pharmacybenefits for 12 months post-index date (follow-up period). Patients were classifiedas having high (> 22), moderate (> 10 to ≤ 22), or low disease activity (> 2.8 to ≤ 10),or in remission (0 to ≤ 2.8) based on CDAI scores. All-cause and RA-related healthcare costs and utilization during the follow-up period were assessed. A total of 3,749 matched RA patients were identified, and 24.11%, 31.93%, and26.91% had high, moderate, and low disease activity, respectively, and 17.04% werein remission. RA patients were, on average, age 57 years, 76% were female, andmost resided in Washington (77%), with average all-cause total costs of $27,008and RA-related costs of $5,262 during the 12-month follow-up period. The averagenumber of office visits was higher for patients with high disease activity (12.31),followed by 11.79, 11.71, and 11.59 for patients with moderate disease activity, lowdisease activity, and for those in remission. Primary cost drivers were outpatientand pharmacy costs, resulting in total all-cause costs of $28,054, $27,285, $26,633,and $25,600, and total RA-related costs of $5,511, $5,280, $4,893, and $5,461 forpatients with high, moderate, and low disease activity, and for those in remission,respectively. RA patients with high disease activity, measured byCDAI score, have a substantial economic burden.Article Citation - WoS: 17Citation - Scopus: 23Benefit of Early Discharge Among Patients With Low-Risk Pulmonary Embolism(2017) Wang, Li; Wells, Phil; Fermann, Gregory J; Peacock, W. Frank; Schein, Jeff; Coleman, Craig I; Crivera, Concetta; Başer, OnurClinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with >= 1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for >= 12 months pre-and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index. Propensity score matching (PSM) was used to compare 90-day adverse PE events (APEs) [recurrent venous thromboembolism, major bleed and death], hospital-acquired complications (HACs), healthcare utilization, and costs among short (<= 2 days) versus long length of stay (LOS). Net clinical benefit was defined as 1 minus the combined rate of APE and HAC. Among 6,746 PE patients, 95.4% were men, 22.0% were African American, and 1,918 had LRPE. Among LRPE patients, only 688 had a short LOS. After 1:1 PSM, there were no differences in APE, but short LOS had fewer HAC (1.5% vs 13.3%, 95% CI: 3.77-19.94) and bacterial pneumonias (5.9% vs 11.7%, 95% CI: 1.24-3.23), resulting in better net clinical benefit (86.9% vs 78.3%, 95% CI: 0.84-0.96). Among long LOS patients, HACs (52) exceeded APEs (14 recurrent DVT, 5 bleeds). Short LOS incurred lower inpatient ($2,164 vs $5,100, 95% CI: $646.8-$5225.0) and total costs ($9,056 vs $12,544, 95% CI: $636.6-$6337.7). LRPE patients with short LOS had better net clinical outcomes at lower costs than matched LRPE patients with long LOS.Article Citation - WoS: 3Citation - Scopus: 3Cancer Chemotherapy Treatment Patterns and Febrile Neutropenia in the Us Veterans Health Administration(2014) Wang, Li; Dale, David C; Barron, Richard; Langeberg, Wendy J; Başer, OnurBackground: The Veterans Health Administration (VHA) is the largest integrated health care system in the United States and a major cancer care provider. Objective: To use VHA database to conduct a population-based study of patterns of myelosuppressive chemotherapy use and to assess the incidence and management of febrile neutropenia (FN) among VHA patients with lung, colorectal, or prostate cancer or non-Hodgkin lymphoma (NHL). Methods: Data were extracted for the initial myelosuppressive chemotherapy course for 27,899 patients who began treatment in the period 2006 to 2011. FN-related costs were defined as claims containing FN diagnosis. Results: Most patients were men (98.0%); most were 65 years or older (55.8%). Patients received a mean 3.4 to 3.9 chemotherapy cycles/course (median cycle duration 34-43 days). The incidence of FN among patients with lung, colorectal, or prostate cancer or NHL was 10.2%, 4.6%, 5.4%, and 17.3%, respectively. Primary or secondary prophylactic antibiotics/colony-stimulating factors were received by 21% and 12% of patients, respectively. Antibiotics were more commonly given as primary or secondary prophylaxis for patients with lung, colorectal, and prostate cancer; colony-stimulating factors were more common for patients with NHL. Among patients with FN, those with lung cancer had the highest inpatient mortality (10%); patients with NHL had the highest costs ($24,571) and the longest hospital length of stay (15.4 days). Conclusions: VHA cancer care was generally consistent with National Comprehensive Cancer Network recommendations; however, compared with the general population, chemotherapy cycles were longer, combination chemotherapy was used less, and treatment to prevent FN was used less, differences that may be attributed to the unique VHA patient population. The impact of these practices warrants further investigation.Article Citation - WoS: 41Citation - Scopus: 39Clinical and Economic Burden Associated With Cardiovascular Events Among Patients With Hyperlipidemia: a Retrospective Cohort Study(2016) Wang, Li; Quek, Ruben G. W; Fox, Kathleen M; Gandra, Shravanthi R; Li, Lu; Başer, OnurBackground: Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia. Methods: Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate-and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period). Results: Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75 % of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE. Conclusions: Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.Conference Object Comparative Persistence With Antihyperglycemic Agents (aha) Used To Treat Type 2 Diabetes Mellitus (t2dm) in the Real World(2016) Cai, J; Wang, Y; Başer, Onur; Xie, L; Diels, J; Neslusan, C; Chow, W....Conference Object Comparing Costs and Resource Utilization Between Patients With Schizophrenia Treated With Paliperidone Palmitate or Oral Atypical Antipsychotics in California Medicaid (medi-Cal)(2015) Pesa, J; Wang, L; Yuce, H; Başer, Onur...Conference Object Comparing Health Care Resource Utilization and Costs Among Obese Patients in the Us Medicaid Population(2016) Zhang, Q; Zhao, Y; Keshishian, A; Xie, L; Yuce H.; Başer, OnurObjectives : To evaluate health care resource utilization and costs among obese patients in the U.S. Medicaid population.Conference Object Comparison of All-Cause Mortality Rate and Economic Burden Between Newly Diagnosed Alzheimer’s Disease Patients Who Received Anti-Dementia Treatment Versus Not: a Longitudinal Retrospective Study(2016) Black, CM; Hu, X; Khandker RK; Ambegaonkar, BM; Kariburyo, M. Furaha; Xie, L; Başer, Onur; Yuce, H....Conference Object Comparison of Major-Bleeding Risk and Health Care Costs Among Treatment-Naïve Non-Valvular Atrial Fibrillation Patients Initiating Apixaban, Dabigatran, Rivaroxaban, or Warfarin(2015) Amin, Alpesh; Keshishian, A; Xie, L; Başer, Onur; Price, K; Vo, L; Singh, P; Bruno, A; Mardekian, J; Tan, W; Singhal, S; Patel, C; Odell, K; Trocio J....Conference Object Comparison of Short Term Bleeding-Related Health Care Utilization and Costs Among Treatment-Naïve Non-Valvular Atrial Fibrillation Patients Initiating Apixaban, Dabigatran, Rivoxaban or Warfarin(2015) Keshishian, A; Xie, L; Başer, Onur; Price, K; Vo, L; Singh, P; Bruno, A; Mardekian, J; Tan, W; Singha, S; Patel C; Odell, K; Trocio J....Article Creating National Weights for a Patient-Level Longitudinal Database(2016) Başer, Onur; Li Wang; Maguire J.To create a nationally-representative estimate from longitudinal data by controlling for sociodemographic factors and health status. The Agency for Healthcare Research and Quality’s (AHRQ) Medicare Expenditures Panel Survey (MEPS) was used as the basis for adjustment methodology. MEPS is a data source representing health insurance coverage cost and utilization, and comprises several large-scale surveys of families, individuals, employers, and health care providers. Using these data, we created subset populations. We then used multivariate logistic regression to construct demographics and case-mix-based weights, which were applied to create a population sample that is similar to the national population. The weight was derived using the inverse probability of the weighting approach, as well as a raking mechanism. We compared the results with the projected number of persons in the US population in the same categories to examine the validity of the weights. The following variables were used in the logistic regression: Age group, gender, race, location, income level and health status (Charlson Comorbidity Index scores and chronic condition diagnosis). Relative to MEPS data, patients included in the private insurance data were more likely to be male, older, to have a chronic condition, and to be white (p=0.0000). Adjusted weighted values for patients in the commercial group ranged from 15.47 to 36.36 (median: 16.91). Commercial insurance and MEPS data populations were similar in terms of their socioeconomic and clinical categories. As an outcomes measure, the predicted annual number of patients with prescription claims from private insurance data was 6 963 034. The annual number of statin users were predicted as 6 709 438 using weighted MEPS data. National projections of large-scale patient longitudinal databases require adjustment utilizing demographic factors and case-mix differences related to health status.Conference Object Demographic and Clinical Characteristics of Patients With Polycythemia Vera (pv) in the Us Veterans Population(2016) Parasuraman S; Yu J; Paranagama D; Shrestha S; Wang L,; Başer, Onur...Conference Object Demographic and Socioeconomic Characteristics That Impact Selection of Oral Anticoagulants Among Non-Valvular Atrial Fibrillation Patients(2016) Keshishian, A; Du, J; Xie, L; Yuce H.; Başer, Onur...Conference Object Demographic Distribution and Health Care Burden of Patients Diagnosed With Ankylosing Spondylitis in the Us Medicare Population(2015) Mao, X; Li, L; Shrestha, S; Başer, Onur; Yuce, H; Wang, LOBJECTIVES: To investigate the demographic distribution and health care burdenof patients diagnosed with ankylosing spondylitis (AS) using Medicare fee-forservice (FFS) data. METHODS: A retrospective analysis was performed using the100% Medicare FFS Datasets from October 1, 2008 through December 31, 2012.Patients diagnosed with AS were identified using International Classification ofDiseases, 9th Revision, Clinical Modification diagnosis code 720.0, and the firstdiagnosis date was designated as the index date. All patients were required tohave continuous medical and pharmacy benefits 1-year pre- (baseline period)and post-index date (follow-up period). Health care resource utilization and costsduring the baseline and follow-up periods were calculated. RESULTS: A total of8,990 AS patients were included in the study. The average age at diagnosis was 75years. Nearly 88.7% of patients were white, 62.97% were women and many residedin the South U.S. region (40.33%). The most common baseline comorbidities werechronic obstructive pulmonary disease (33.20%), diabetes (30.50%), cerebrovasculardisease (22.65%) and congestive heart failure (18.85%). During the follow-up period,73.04% of patients had inpatient admissions, 52.31% had emergency room visits,91.43% had outpatient office visits, 91.43% had outpatient visits and 57.67% hadpharmacy visits, resulting in average costs of, $37,077, $298, $5,397, $5,695 and$6,668, respectively. The average total costs were $49,440 during the follow-upperiod. The four most frequently prescribed medications for AS were prednisonehydrocodone (3.59%), bit/acetaminophen (3.17%), methotrexate sodium (2.79%)and levothyroxine sodium (2.42%). CONCLUSIONS: AS patient demographic andclinical characteristics in the Medicare population were assessed. Study patientswere often diagnosed with comorbid conditions, and had high health care utilization and costs.Article Citation - WoS: 4Citation - Scopus: 6Does the Unification of Health Financing Affect the Distribution Pattern of Out-Of Health Expenses in Turkey?(Wiley, 2019) Çınaroğlu, Songül; Başer, OnurTurkey has implemented health reforms for over a decade and has taken significant steps toward unifying health financing. This study investigated the financial burden associated with out-of-pocket (OOP) expenditures under universal health coverage, using national 2003–2015 household budget data from the Turkish Statistical Institute. Progress was evaluated using Kakwani–Suits indices and Lorenz concentration curves. The results indicate that overall, more than a decade after its unification, redistribution of wealth in the Turkish health financing system has benefitted the wealthy but not the poor. Both curve and index approaches (Kakwani index 2003 = -0.50; 2015 = -0.44) reveal an increasingly regressive pattern of OOP health expenditures. The effective use of fiscal space and good political leadership are essential for the successful continuation of reforms to combat poverty in Turkey.
